In an article published in CLM Magazine, MARC members Greg McKenna and Heather Sanderson discuss how the SPARC Act (H.R. 1122) could bring needed changes to improve the Medicare Secondary Payer (MSP) law. “When Congress created the Part D program in 2003 as part of the Medicare Modernization Act (MMA), it failed to address secondary payer issues beyond simply stating that Part D Prescription Drug Plans’ secondary payer rights were ‘in the same manner’ as Medicare Advantage Plans,” they wrote, adding that “this process is inefficient and costly to enforce.”
The authors go on to explain that the SPARC Act “would make clear who is responsible for prescription drug costs and when they must be reimbursed. It would also clarify when that responsibility begins, how a prescription drug plan (PDP) can recover past payments, and when and how CMS must share data to help facilitate the secondary payer recovery process.” McKenna and Sanderson conclude that the SPARC Act “would provide commonsense reforms to improve healthcare outcomes for Medicare Part D beneficiaries, insurance carriers, and PDPs.”
